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Flashcards in uncontrolled systemic inflammation Deck (19):
1

What is the systemic response to a severe infection?

Cytokines and inflammatory mediators released into blood
Can lead to severe sepsis, septic shock, disseminated intravasular coagulation and multi-organ dysfunction syndrome

2

What are the criteria for Systemic inflammatory response syndrome (SIRS)?

Any of the following 2
Fever more than 38 or less than 36
HR higher than 90 BPM
Respiratory rate more than 20 breaths pm
PaCO2 less than 32 mmHg
Abnormal WBC count (>12,000 or <4,000)

3

What is a band cell?

Immature neutrophil

4

When would band cells appear in the blood?

When there is an inc need for neutrophils but its exceeds the bone marrow's ability to make them
Usually half formed

5

What is acute phase response?

Release of various proteins from liver in response to stimulation from IL-6 and other cytokines

6

What is sepsis?

SIRS due to documented infection

7

What is severe sepsis?

Sepsis with any sign of organ dysfunction

8

Define septic shock.

Infection-induced hypotension that is unresponsive to attempts at volume expansion (IV fluids)

9

What is disseminated intravascular coagulation (DIC)?

Systemic activation followed by depletion of clotting factors and subsequent hemorrhage

10

Define multi-organ dysfunction syndrome.

Varying degrees of organ impairment secondary to SIRS

11

What is compensatory anti-inflammatory response (CARS)?

Unregulated anti-inflammatory response leading to immune suppression and inc risk of infection

12

What is acute respiratory distress response (ARDS)?

Inflammation to the lungs
Inflam moderators cause inc vascular permeability and up-regulation of adhesion molecules
Fluid, protein and neutrophils leave lung and enter alveoli
Results in hypoxia and bilateral pulmonary infiltrates

13

What role does TNF-alpha play in sepsis/DIC?

Inc vascular permeability
Up-regulates adhesion molecules on endothelial cells
Induce expression of tissue factor on endothelial cells

14

What role does IL-1 play in sepsis/DIC?

Induce fever
Up-regulate adhesion molecules on endotheial cells

15

What role does IL-6 play in sepsis/DIC?

Release of acute phase proteins from liver
Induce expression of tissue factor on endothelial cells

16

C5a and C3a lead to release of mediators from ____.

Mast cells

17

System release of bacterial toxins and inflammatory mediators can lead to systemic inc in vascular permeability which in turns leads to;

Hypotension and pulmonary edema (ARDS)

18

What leads to activation of clotting systems?

Cytokines and endotoxins

19

If the system becomes hypotensive and clotting systems are activated what could that lead to?

Decreased organ perfusion (MODS) and ischemic necrosis (plague)